A cognitive interference model of sexual functioning for gay men: the relationship between internalized homophobia and erectile function

Gay men more frequently report erectile difficulties than heterosexual men, possibly due to the additional stress gay men experience as a result of their sexual minority status. Internalized homophobia (IH), defined as the internalization of negative societal attitudes about being gay, is associated with adverse sexual outcomes. However, the mechanisms underlying this relationship remain unclear. According to Barlow’s model of sexual dysfunction, cognitive interference plays a key role in the development and maintenance of erectile dysfunction. The present study examined the cross-sectional and longitudinal relationships between IH, cognitive anxiety symptoms, and erectile function in a sample of 252 HIV-negative gay and bisexual men. Participants completed a battery of self-report questionnaires assessing internalized homophobia, cognitive anxiety symptoms, and erectile functioning at baseline, 3-month, and 6-month follow-ups. Cognitive anxiety symptoms did not mediate the relationship between IH and erectile function at baseline or across 6-months. Limitations and future directions are discussed.